Methods of use of skin wound healing compositions

ABSTRACT

A wound healing composition comprising a class of polypeptide compounds having a polypeptide chain with 5 to 120 amino acid units per chain. The composition includes a pharmaceutical medium to carry the polypeptide compound, such as an aqueous solution, suspension, dispersion, salve, ointment, gel, cream, lotion, spray or paste. Additionally, a method of applying a wound healing composition comprising a class of polypeptide compounds having a polypeptide chain with 5 to 120 amino acid units per chain in a concentration of from about 1 μg/ml to about 100 μg/ml for a time sufficient to heal the wound is disclosed.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of U.S. patentapplication Ser. No. 12/505,361, entitled “Skin Wound HealingCompositions and Methods of Use Thereof,” filed Jul. 17, 2009, attorneydocket number 028080-0477, the entire content of which is incorporatedherein by reference.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH

This invention was made with government support under Grant Nos. GM67100and AR46538 awarded by the National Institutes of Health. The governmenthas certain rights in the invention.

BACKGROUND

1. Field of the Disclosure

This disclosure resides in the field of wound healing compositions anduse thereof. Particularly, this disclosure relates to compositions ofpolypeptides and the topical application of these compositions to theskin to expedite wound healing by promoting all skin cell migration.

2. Description of the Related Art

Wound healing, or wound repair, is an intricate process in which theskin repairs itself after injury. In normal skin, the epidermis(outermost layer) and dermis (inner or deeper layer) exists in asteady-stated equilibrium, forming a protective barrier against theexternal environment. The normal wound healing process can be broadlyclassified into three stages namely the inflammatory, proliferative andmaturation phases. The inflammatory phase lasts 0-2 days and involves anorderly recruitment of cells to the wound area. This is followed by the2-6 day proliferative phase, in which fibroblasts, keratinocytes andother cells in the wound bed begin to actively proliferate to close thewound. During the first phase of tissue repair, an acute inflammatoryresponse with cellular migration occurs. Neutrophils predominate for thefirst 24-48 hours; macrophages become active by the third day. Theneutrophils and macrophages phagocytose and digest pathologic organismsand tissue debris. The maturation phase follows the proliferative phase,peaking at 21 days, by which time the wound is completely healed byrestructuring the initial scar tissue.

A problematic wound does not follow the normal time table for thehealing process as described above. The increased time required for aproblematic wound can cause unwanted cost and pain associated with theslowed healing, as well as a decrease in job production and overallquality of life. Among the two million people diagnosed yearly withpressure ulcers, 900,000 have non-healing lower extremity ulcers. It isestimated that 18% of patients with diabetes over the age of 65 willhave chronic, non-healing foot ulcers. Moreover, 50,000 lower extremityamputations are performed each year due to infected lower leg chronicwounds. The quality of life due to morbidity of non-healing leg ulcersis significantly compromised because of wound odor, infection, and pain.In addition, these issues also lead to social isolation and diminishedself-image in patients with chronic skin wounds. Financially, the costfor managing delayed wound healing in the US elderly is estimated at $9billion per year.

A great deal of time and expense has been utilized in the field ofchronic wound healing. Akella et al. discloses in U.S. Pat. No.7,081,240, the use of a protein mixture for treating wounds, wherein themixture is isolated from bone or produced from recombinant proteins suchas bone morphogenetic proteins, transforming growth factors andfibroblast growth factors. However, the overall clinical outcomes ofgrowth factor therapy have been disappointing and few growth factorshave ultimately received FDA approval.

Kiss discusses the use of non-growth factor proteins for use in woundhealing comprised of human alpha1-antitrypsin, human placental alkalinephosphatase, human transferring and α₁-acid glycoprotein. However, thismethod's draw back is that it requires the complicated sequentialapplication of several agents that act at different steps, and also mayrequire adjustment of the compositions according to each treatment.Similarly, the use of skin substitutes has not been cost-effective.

Re-epithelialization is a critical event in human skin wound healing, inwhich epidermal keratinocytes laterally migrate to close a wound. Inchronic wounds, keratinocyte migration is blocked and the wounds remainopen, causing patient morbidity and even fatality.

During human skin wound healing, a critical rate-limiting step is theinitiation of the resident epidermal and dermal cells at the wound edgeto migrate into the wound bed. Human keratinocytes (HKCs) laterallymigrate across the wound bed from the cut edge to eventually close thewound, the process known as re-epithelialization. The dermal cells,including dermal fibroblasts (DFs) and dermal microvascular endothelialcells (HDMECs), start to move into the wound following the HKCmigration, where these cells deposit matrix proteins, contract andremodel the newly closed wound and build new blood vessels. HKCmigration is largely driven by TGFα in human serum and is not affectedby high concentrations of TGFβ family cytokines co-present in humanserum. In contrast, the presence of TGFβ blocks the dermal cellmigration even in the presence of their growth factors, such as PDGF-BBand VEGF. Therefore, while it is understandable why HKC migrationjumpstarts ahead of DF and HDMEC migration during wound healing, it hasremained as a puzzle how DFs and HDMECs move into the wound bed in thepresence of abundant TG Fβ.

Other research has involved the use of heat shock protein to promotewound healing. For example, Srivastava et al. discloses in U.S. Pat. No.6,475,490 compositions comprising heat shock proteins, including gp96,hsp90, and hsp70, uncomplexed or complexed noncovalently with antigenicmolecules. However, the use of the entire length of these largemolecules in pharmaceutical compositions results a reduced efficacy perunit weight of the protein.

SUMMARY

In order to overcome the above mentioned problems, this disclosureidentifies a wound healing composition comprising a class of polypeptidecompounds having a polypeptide chain of relatively low size. In oneembodiment of the present disclosure, the polypeptide chain has 5 to 120amino acid units per chain. Optionally, the composition includes apharmaceutical medium to carry the polypeptide compound, such as anaqueous solution, suspension, dispersion, salve, ointment, gel, cream,lotion, spray or paste.

In another embodiment of the present disclosure, the polypeptide chainhas from 20 to 60 amino acid units per chain. Optionally, thepolypeptide chain comprises the amino acid sequences of hsp90α peptidefrom amino acids 236 to 350, SEQ ID NO:1:EEKEDKEEEKEKEEKESEDKPEIEDVGSDEEEEKKDGDKKKKKKIKEKYIDQEE, or SEQ ID NO: 2:SDEEEEKKDGDKKKKKKIKEKYIDQEE. Optionally, the composition can comprise amixture of polypeptide chains of from 5 to 120 amino acid units, 20-60amino acid units or the specific amino acid units shown above.

The present disclosure is also directed to a method of healing a skinwound comprising contacting a first effective amount of a pharmaceuticalcomposition consisting of a polypeptide compound having a polypeptidechain to the skin wound. The polypeptide chain is from 5 to 120 aminoacid units per chain, 20 to 60 amino acid units per chain, or comprisesthe amino acid sequences of hsp90α peptide from amino acids 236 to 350,SEQ ID NO: 1: EEKEDKEEEKEKEEKESEDKPEIEDVGSDEEEEKKDGDKKKKKKIKEKYIDQEE, orSEQ ID NO: 1: SDEEEEKKDGDKKKKKKIKEKYIDQEE.

The method optionally uses a pharmaceutical composition having apharmaceutical medium to carry the polypeptide compound, consisting ofan aqueous solution, suspension, dispersion, salve, ointment, gel,cream, lotion, spray or paste.

In another embodiment, the polypeptide compound is formulated in aconcentration of from about 10 μg/ml to about 3 mg/ml in saidpharmaceutical medium. Optionally, the polypeptide compound isformulated in a concentration of from about 30 μg/ml to about 500 μg/mlin said pharmaceutical medium.

In one embodiment of the method of wound healing, the composition isapplied to the wound about every 6 to about every 72 hours. Optionally,the composition is applied to the wound about every 24 to about every 48hours.

Additional advantages and other features of the present disclosure willbe set forth in part in the description which follows and in part willbecome apparent to those having ordinary skill in the art uponexamination of the following or may be learned from the practice of thedisclosure. The advantages of the disclosure may be realized andobtained as particularly pointed out in the appended claims.

As will be realized, the present disclosure is capable of other anddifferent embodiments, and its several details are capable ofmodifications in various obvious respects, all without departing fromthe disclosure. Accordingly, the drawings and description are to beregarded as illustrative in nature, and not as restrictive.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a bar graph showing various efficacies of polypeptidecompounds and their effects on wound healing in mice as compared to acontrol cream.

FIGS. 2 a-f are pictures of the results of skin wound healing of micecomparing a polypeptide having a peptide chain with 115 amino acids vs acontrol cream.

FIGS. 3A-3E are pictures of the results of skin wound healing of micecomparing an FDA approved compound (Regranex™, PDGF-BB) vs a controlcream.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

Not to be bound by theory, it is believed that following skin injury,paracrine- or autocrine-released TGFα stimulates membrane translocationand secretion of pre-existing hsp90α proteins in HKCs. The secretedhsp90α jumpstarts HKC migration, a critical event ofre-epithelialization process, by binding to the CD91/LRP-1 receptor onthe cell surface. When extracellular hsp90α defuses into and reachedcertain concentration in the wound bed, it starts to induce migration ofDFs and HDMECs from the cut edge into the wound bed even under “hazard”conditions: no ATP and ATPase activity and in presence of general cellmotility inhibitors, such as TGFβ family cytokines. Thus, extracellularhsp90α is utilized for skin wound healing. However, when chronic woundsare present, the skin is unable to produce hsp90α for wound healing.Thus, an additive to promote skin wound healing must be applied to thewound.

FIG. 1 contains a list of amino acid sequences that were tested for invitro efficacy as compared to a control medium. The amino acid sequencesare identified in FIG. 1 as follows:

F-5 fragment: (SEQ ID NO: 1):EEKEDKEEEKEKEEKESEDKPEIEDVGSDEEEEKKDGDKKKKKKIKEKYI DQEEUSC-peptide 2: (SEQ ID NO: 2): SDEEEEKKDGDKKKKKKIKEKYIDQEE

As can be seen in FIG. 1, the full-length (WT) hsp90α showed aremarkable pro-motility activity, in comparison to the control medium.The middle domain plus the charged sequence (M-1) show a similar degreeof the activity as the WT hsp90α. However, the middle domain lacking thecharged sequence showed a significantly decreased activity (M-2),although the charged sequence plus the entire N′-terminal domain (N′)showed no stimulating activity. The two C′-terminal domains (C′-1 andC′-2, made to ensure the results) both showed a moderate pro-motilityactivity. Therefore, hsp90α promotes HKC migration mainly through itsmiddle and the carboxyl domains, consistent with their surface locationin hsp90α. Accordingly, a composition comprising the middle domain ofhsp90α would exhibit similar wound healing properties as that of acomposition comprising hsp90α alone.

However, as can also be seen in FIG. 1, not all of the full hsp90αprotein or the entire middle domain and charged portion of hsp90αprotein is necessary to promote wound healing. The F-3 fragmentconsisting of 115 amino acid units which is from amino acid number 236to 350 and the F-5 fragment having 54 amino acid units from amino acidnumber 236 to 289 (SEQ ID NO: 1 EEKEDKEEEKEKEEKESEDKPEIEDVGSDEEEEKKDGDKKKKKKIKEKYIDQEE) exhibit similar activity as that of fulllength hsp90α, that being 100% on cell migration. Thus, the unnecessaryportions of hsp90α need not be included in a composition for woundhealing, thereby allowing a composition to be more efficacious perweight of active wound healing agent. Moreover, instead of relying oncomplicated isolation and extraction methods to obtain the hsp90αprotein or the middle domain plus charged portion of hsp90α protein,more inexpensive and conventional methods of synthesis may be employedto obtain the lower chain length polypeptide chains.

To prove the efficacy of polypeptide compounds of 115 amino acid unitsand 54 amino acid units were synthesized via convention means. 100 μgF-3 fragments in 100 μl of 10% Carboxymethylcellulose cream and thecream alone was topically applied to the Icm×Icm wound on the back ofnude mice daily for 5 days, and wounds were analyzed every two days.Selected wound images of a representative experiment are shown in FIGS.2A-2F. It can be seen that F-3 significantly accelerated closure of thewounds beginning on day 4, day 6, day 8, day 11, day 13 and day 15 ascompared to the cream control.

EXAMPLE

In the example below, the following conditions or methods were utilized.

The pharmaceutical 100 μl of 10% carboxymethylcellulose cream (Sterile)is mixed in and the 1 cm×1 cm wound on the back of a nude mouse istopically covered. Following this treatment, the wound is covered with afew antibiotics and bandi and the bandi are fixed by rolling the mousewith coban. The F-3 compound mixture is then added every day for up tofive days and the wound is analyzed every two days.

To prepare mice for topical treatment of F-3, 1.0-cm×1.0-cmfull-thickness excision wounds were made by lifting the skin withforceps and removing full thickness skin with a pair of scissors on themid-back of 8 to 10 week old mice. The wounds were topically covered by100 μl 10% carboxymethylcellulose either without (as a control) or with300 μg recombinant F-3 compound. The wound area was then covered withBand-Aid and Coban, a self-adherent wrap, to prevent desiccation. Onlyone dose of F-3 compounds was administered to the wound. To measure thewound area, standardized digital photographs were taken of the wounds at4, 6, 8, 11, 13 and 15 days post-wounding and the open wound areas weredetermined with an image analyzer (AlphaEase FC version 4.1.0, AlphaInnotech Corporation). Percentage of wound area was defined by comparingareas of healing wounds to those of the original wounds. The Student Ttest was used for the statistical analysis. All animal studies wereconducted using protocols approved by the University of SouthernCalifornia Institutional Animal Use Committee.

The following example is offered for purposes of illustration and arenot intended to limit the scope of the invention.

A 1.0-cm² (lcm×lcm) square full-thickness excision wound was made on themid-back of 8 to 10 week old athymic nude mice and the pharmaceuticalcomposition of F-3 was applied topically daily for 5 days (n=10 mice pergroup). (A) Representative day 4, 6, 8, 11, 13 and 15 wounds are shown.Wound sizes were significantly reduced in mice topically treated withthe cream containing F-3 (right panels), but not cream alone (leftpanels). (B) Mean±SD wound size measurements at day 4, 6, 8, 11, 13 and15 post-wounding (n=10 mice for each group).

To compare efficacy of the F-3 compound, a study using FDA approvedRegenerex™ was conducted. Using the above methods, a 40 μg dose ofPDGF-BB (Regenerex™) was applied to mice for 5 days (n=10 mice pergroup) vs F-3 compound. (A) Representative day 0, 5, 7, 10 and 12 woundsare shown in FIGS. 3A-3E. As can be seen from the figures, wound sizeswere significantly reduced in mice topically treated with the creamcontaining F-3 (upper panels), but not Regenerex™ (lower panels).

The present disclosure can be practiced by employing conventionalmaterials, methodology and equipment. Accordingly, the details of suchmaterials, equipment and methodology are not set forth herein in detail.In the previous descriptions, numerous specific details are set forth,such as specific materials, structures, chemicals, processes, etc., inorder to provide a thorough understanding of the disclosure. However, itshould be recognized that the present disclosure can be practicedwithout resorting to the details specifically set forth. In otherinstances, well known processing structures have not been described indetail, in order not to unnecessarily obscure the present disclosure.

Only a few examples of the present disclosure are shown and describedherein. It is to be understood that the disclosure is capable of use invarious other combinations and environments and is capable of changes ormodifications within the scope of the inventive concepts as expressedherein.

The Sequence listing in “SEQUENCE LISTING.TXT” created on Mar. 22, 2011,being 1.04 KB in size is incorporated by reference.

1. A method of healing a skin wound comprising: contacting a firsteffective amount of a pharmaceutical composition consisting of apolypeptide compound having a polypeptide chain to the skin wound,wherein the polypeptide chain consists of 5 to 120 amino acid units perchain.
 2. The method of healing a skin wound according to claim 1,wherein the pharmaceutical composition further comprises apharmaceutical medium to carry the polypeptide compound, wherein thepharmaceutical medium is at least one selected from the group consistingof: an aqueous solution, suspension, dispersion, salve, ointment, gel,cream, lotion, spray or paste.
 3. The method of healing a skin woundaccording to claim 2, wherein the polypeptide compound is formulated ina concentration of from about 10 μg/ml to about 3 mg/ml in saidpharmaceutical medium.
 4. The method of healing a skin wound accordingto claim 2, wherein the polypeptide compound is formulated in aconcentration of from about 30 μg/ml to about 500 μg/ml in saidpharmaceutical medium.
 5. The method of healing a skin wound accordingto claim 1, wherein the polypeptide chain consists of 20 to 60 aminoacid units per chain.
 6. The method of healing a skin wound according toclaim 5, wherein the pharmaceutical composition further comprises apharmaceutical medium to carry the polypeptide compound, wherein thepharmaceutical medium is at least one selected from the group consistingof: an aqueous solution, suspension, dispersion, salve, ointment, gel,cream, lotion, spray or paste.
 7. The method of healing a skin woundaccording to claim 6, wherein the polypeptide compound is formulated ina concentration of from about 10 μg/ml to about 3 mg/ml in saidpharmaceutical medium.
 8. The method of healing a skin wound accordingto claim 1, wherein the polypeptide chain consists of an amino acidsequence EEKEDKEEEKEKEEKESEDKPEIEDVGSDEEEEKKDGDKKKKKKIKEKYIDQEE (SEQ. IDNO: 1).
 9. The method of healing a skin wound according to claim 1,wherein the polypeptide chain consists of an amino acid sequence ofhuman hsp90α peptide from amino acids 236 to
 350. 10. The method ofhealing a skin wound according to claim 1, wherein the polypeptide chainconsists of an amino acid sequence SDEEEEKKDGDKKKKKKIKEKYIDQEE (SEQ. IDNO. 2).
 11. The method of healing a skin wound according to claim 2,wherein the composition is applied to the wound about every 6 to aboutevery 72 hours.
 12. The method of healing a skin wound according toclaim 6, wherein the composition is applied to the wound about every 24to about every 48 hours.
 13. The method of healing a skin woundaccording to claim 2, wherein the composition is applied to the woundabout every 6 to about every 72 hours.
 14. The method of healing a skinwound according to claim 6, wherein the composition is applied to thewound about every 24 to about every 48 hours.